Schizophrenia

Savannah Pinfold

What is Schizophrenia?

Schizophrenia is a chronic, severe, debilitating mental illness that affects about 1% of the population.It affects men about one and a half times more commonly than women. Schizophrenia usually first appears in a person during their late teens or throughout their twenties. Also, despite its portrayal in movies, schizophrenia isn't a split personality: It literally means “split mind.” Schizophrenia is a lifelong disorder, with treatments since at this time, there is no known cure. Schizophrenia is classified as a psychotic disorder, which means the inability to tell the difference between what is real or imagined.

Types?

Paranoid:

The defining feature of the paranoid subtype (also known as paranoid schizophrenia) is the presence of auditory hallucinations or prominent delusional thoughts about persecution or conspiracy. However, people with this subtype may be more functional in their ability to work and engage in relationships than people with other subtypes of schizophrenia. People diagnosed with the paranoid subtype may not appear odd or unusual and may not readily discuss the symptoms of their illness. Typically, the hallucinations and delusions revolve around some characteristic theme, and this theme often remains fairly consistent over time. A person’s temperaments and general behaviors often are related to the content of the disturbance of thought. For example, people who believe that they are being persecuted unjustly may be easily angered and become hostile.

Disorganized:

As the name implies, this subtype’s predominant feature is disorganization of the thought processes. As a rule, hallucinations and delusions are less pronounced, although there may be some evidence of these symptoms. These people may have significant impairments in their ability to maintain the activities of daily living. Even the more routine tasks, such as dressing, bathing or brushing teeth, can be significantly impaired or lost.

Catatonic:

The predominant clinical features seen in the catatonic subtype involve disturbances in movement. Affected people may exhibit a dramatic reduction in activity, to the point that voluntary movement stops, as in catatonic stupor. Alternatively, activity can dramatically increase, a state known as catatonic excitement.

Undifferentiated:

The undifferentiated subtype is diagnosed when people have symptoms of schizophrenia that are not sufficiently formed or specific enough to permit classification of the illness into one of the other subtypes.

Residual:

This subtype is diagnosed when the patient no longer displays prominent symptoms. In such cases, the schizophrenic symptoms generally have lessened in severity. Hallucinations, delusions or idiosyncratic behaviors may still be present, but their manifestations are significantly diminished in comparison to the acute phase of the illness.

Symptoms

Hallucinations are perceptual experiences which occur without any actual source. In other words, there is no actual stimulus in the environment creating the sound, image, etc. The schizophrenic perceives something as very real even though it isn’t real at all.

2) Voices (Auditory Hallucination): Command, and Disassociated.

These are usually in the form of hearing voices. Schizophrenics may believe they are hearing two or more voices, such as people having conversations or several people talking to them. Or, they may hear one voice. To the schizophrenic, the voice or voices seem very real. They often have no insight into the fact that it is a hallucination.Often the voices are commenting on the schizophrenic’s thoughts or actions. And to make it even more distressing, the voices may be threatening or discouraging. Sometimes the voice or voices are familiar, but this is not always the case. The voices may tell the schizophrenic to harm or kill himself/herself or to harm someone else. Because the voices seem very real, they can be very compelling, making it difficult for the schizophrenic to resist acting on the command.

3) Delusions: Persecutory.

This is the most common type of delusion, where the schizophrenic has the feeling they're being followed or watched. Without them knowing.

4) Disorganization: Speech, and Behaviour.

Schizophrenics have a hard time keeping track of everything. Such things include promises, hygiene, impulses, and emotions. Making up words and phrases, switching rapidly from topic to topic, and and rhyming are common signs as well.

Warning Signs

Social withdrawal.

Hostility or suspiciousness.

Deterioration of personal hygiene.

Flat, expressionless gaze.

Inability to cry or express joy.

Inappropriate laughter or crying.

Depression.

Oversleeping or insomnia.

Odd or irrational statements.

Forgetful; unable to concentrate.

Extreme reaction to criticism.

Strange use of words or way of speaking.

Schizophrenia in Twins

While schizophrenia occurs in one percent of the general population, having a history of family psychosis greatly increases the risk. Schizophrenia occurs at roughly ten percent of people who have a first-degree relative with the disorder, i.e., a parent or sibling. However, the highest risk occurs when an identical twin is diagnosed with schizophrenia. The unaffected twin has a roughly 50 percent chance of developing the disorder.

Brain Structure

Brain chemistry and structure also play an important role. Neurotransmitters, including glutamate and dopamine, are what some scientists believe to be behind the occurrence of schizophrenia. Neurotransmitters are what the brain uses to communicate. Some scientists believe that problems during brain development in utero are the cause for these faulty connections.

Brain imaging technologies, such as fMRI, functional magnetic resonance imaging, and PET, positron emission tomography, which provide for a detailed map of the brain, have shown that individuals diagnosed with schizophrenia have changes in both brain structure and chemistry.

A number of abnormalities have been identified and confirmed, including ventricular enlargement and decreased cerebral (cortical and hippocampal) volume. These are characteristic of schizophrenia as a whole, rather than being restricted to a subtype, and are present in first-episode, unmedicated patients. The ventricular enlargement is accompanied by a loss of brain tissue averaging 3%.

Causes?

Despite a significant amount of research, science has yet to reveal exactly what exactly causes schizophrenia. Some experts believe it is a combination of factors, particularly genetics, brain anomalies, and environmental triggers. Others, however, believe that this complex disorder is actually not a single disorder at all, but several different disorders. This can make pinpointing a cause even more challenging.

Prevention?

Avoid the use of illicit drugs and limit or avoid alcohol. Learn effective ways to cope with stress and negative feelings. Stay actively involved with friends and family – don’t withdraw.

Diagnostic Tests?

When doctors suspect someone has schizophrenia, they typically ask for medical and psychiatric histories, conduct a physical exam, and run medical and psychological tests, including:

Tests and screenings. These may include a lab test called a complete blood count (CBC), other blood tests that may help rule out conditions with similar symptoms, and screening for alcohol and drugs. The doctor may also request imaging studies, such as an MRI or CT scan.

Psychological evaluation. A doctor or mental health provider will check mental status by observing appearance and demeanor and asking about thoughts, moods, delusions, hallucinations, substance abuse, and potential for violence or suicide.

Treatment?

Successful treatment of schizophrenia, depends upon a life-long regimen of both drug and psycho-social support therapies. While the medication helps control the psychosis associated with schizophrenia (e.g., the delusions and hallucinations), it cannot help the person find a job, learn to be effective in social relationships, increase the individual's coping skills, and help them learn to communicate and work well with others. The two main groups of medications used for the treatment of schizophrenia are the older or “typical” anti-psychotic medications and the newer “atypical” anti-psychotic medications.

The typical anti-psychotics (Thorazine) are the oldest anti-psychotic medications and have a successful track record in the treatment of hallucinations, paranoia, and other psychotic symptoms. However, they are prescribed less frequently today because of the neurological side effects. In recent years, newer drugs for schizophrenia have become available. These drugs are known as atypical anti-psychotics (Clozaril) because they work differently than the older anti-psychotic medications, and have fewer side effects.

Alternative Treatments

Living healthy, and going to therapy to learn how to live fully with the disease.

The Hardships

Schizophrenia isn't a simple disorder that you can put off to the side. It affects the person's life, and everyone around them. People with schizophrenia are not dangerous, out of control monsters. They're people too, just like you and I. They have feelings. There are many people in the world who have schizophrenia but you can't tell. With the proper help, they can go back to living a rather normal life. Schizophrenic's face challenges everyday of their life, but with the love and support of their family and friends, it can be a little easier.